Kathleen Sebelius: No more Obamacare delays

HHS Secretary Kathleen Sebelius said Wednesday that there would be no delay of Obamacare’s individual mandate, the penalty for violating it or the March 31 closing date of the enrollment period, the strongest statement yet that the administration has no plans for more major changes to the law in the final weeks of the first sign-up period.

Asked by Rep. Kevin Brady (R-Texas) at a House hearing whether the administration would change its policy for enforcing the individual mandate after all the other delays, extensions and adjustments it has made to different provisions in the law, Sebelius bluntly replied, “No, sir.”

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At the House Ways and Means hearing on the HHS budget, Sebelius defended the agency’s prerogative to provide “special enrollment periods” for some groups of people, such as those who had trouble signing up in an exchange and went outside the new market for coverage. But she maintained that regular enrollment would close at the end of the month.

The hearing was ostensibly about the agency’s proposed budget, but Republicans primarily hammered Sebelius with questions about the Obama administration’s goals for the federal health care law and what is known about the enrollment numbers that have been reported so far.

Sebelius was asked repeatedly whether the administration could say how many people who had enrolled in plans had actually paid their premiums, but she said she couldn’t answer.

On Tuesday, HHS said that 4.2 million people had signed up for private insurance plans under Obamacare through the end of February. That’s way off pace for the administration’s initial goal of 7 million enrollments this year, now viewed as unattainable. Even reaching a revised target of 6 million projected by the Congressional Budget Office after the disastrous rollout of HealthCare.gov is a daunting challenge. A new report Wednesday by Avalere Health said reaching the lower goal was highly unlikely, estimating 5.4 million enrollments by the end of March.

The answer to how many of the sign-ups have paid is important because that’s who will have actually gained insurance under the law. The number is bound to be significantly less than those who have simply chosen plans — four large insurers estimated to POLITICO this week that 15 percent to 20 percent of people who signed up hadn’t paid.

But Sebelius said the agency only receives “aggregate data” from insurers about those who have paid premiums and are eligible for tax credits — HHS pays those subsidies to insurers — but not the detailed individual information needed to answer Price’s question.

“This is not Medicare or Medicaid, sir, this is a private plan in a private market,” she said, calling the information a snapshot of “one portion of the market.” The insurers themselves are the only ones with the full accounting, she said.

Chairman Dave Camp (R-Mich.) pointed out that the administration reports how many young adults remained on their parents’ plans under the Affordable Care Act, even though that also comes from data that only the insurers have.

“I’m telling you, as soon as we have this information,” Sebelius responded. “We don’t collect it. They turned it directly in to us.”

He asked if Sebelius had asked insurers for a report on who has paid, but Sebelius did not answer, saying only that the agency would know once the information technology system was in place to do the accounting automatically. Agency officials have said that likely won’t be finished until the summer, months after open enrollment closes.

Pressed on the administration’s definition of enrollment success at the hearing, Sebelius declined to specify a number.

“Success looks like millions of people with affordable coverage which they will have by the end of March,” she said.